ASI • Medical Status • Life interference • Due to addiction • Assessed need for medical intervention • Education, Employment, Finances • Level of education • Occupational hx forever and last 30 days • Drivers license/transportation • Sources of financial support • Dependents • Perception of employment / financial issues • Assessed need for employment counseling ASI • Alcohol/Drug Use • Drugs (addictive behaviors) used, pattern and method • Amount of money spent • Which drugs (behaviors) most problematic • Voluntary abstinence – When, for how long, how and what triggered relapse • Hx of medical problems due to use • Treatment Hx • Perception of the need for treatment • Assessed need for treatment ASI • Legal status • Probation or parole • Is treatment court mandated • Are you awaiting trial / pending charges • Catalog charges and frequency • How many charges are addiction related • How many charges resulted in convictions • How many times have you been incarcerated? • How many days in the last 30 have you been in jail • Perception of legal problems • Assessed need for legal services/counseling

ASI • Family/Social History • Identify history of addiction or psychiatric issues in 1st and 2nd degree family members • Marital status and satisfaction • Living arrangements and satisfaction (Recovery environment) • Use of alcohol or drugs in the household • With whom do you spend most of your time • Who are your close friends • Have you had serious difficulty getting along with any first degree family member, coworker or friend • Trauma/abuse history • Perception of interpersonal problems • Assessed need for family/social counseling

ASI • Psychiatric • How many times hospitalized • Number of times ever and 30 days you have experienced depression, anxiety, hallucinations, cognitive difficulties, suicidal ideation, • Are you on or have you ever been on psychiatric medications • Perception of psychiatric issues • Assessed need for mental health counseling Process Review • An assessment is conducted. • Data and information are collected from the client, collateral sources, and assessment scales. • Problems are identified. • Readiness for change for each problem is identified • Problem statements are prioritized. • Goals are created that address the problems. • Objectives to meet the goals are defined • Interventions are revised or changed based on client response to treatment

Treatment Plan Overview • Program-driven plans • Are one-size-fits all • Reflect the components and/or activities and services available in the program • Individualized Treatment Plan is “Sized” to Match Client Needs • Not all clients have the same needs or are in the same situation. • The individualized treatment plan is made to “fit” the client based on her/his unique: • Abilities • Goals • Lifestyle • Socioeconomic realities • Work history • Educational background • Culture • When treatment programs do not offer services that address specific client needs, referrals to outside services are necessary.

• “Client has low self-esteem.” • Client averages 10 negative self-statements daily • “Client is in denial.” • Client reports two DWIs in the past year but states that alcohol use is not a problem. • “Client is resistant to treatment.” • In the past 12 months, the client has dropped out of 3 treatment programs prior to completion. (other possibilities?) • “Client is on probation because he is a bad alcoholic.” • Client has legal consequences because of alcohol-related behavior.

Terms • What Components Are Found in a Treatment Plan? • Problems identified during assessment • Goals reasonably achievable in the active treatment phase • The term objectives used in this training is defined as what the client does to meet the goals • The term intervention used in this training is defined as what the staff will do to assist the client

Prioritizing Problems Writing a Specific Goal • Recovery is not a specific goal • When a goal is specific, the person can objectively evaluate the data to determine that it has been achieved. • What problems are you experiencing as a result or your condition? (Problem statement) • High blood pressure • Insomnia • Relationship problems • Depression • Financial problems—Job loss and difficult with employment due to felony conviction Writing a Specific Goal • How will you know when each of those problems is resolved? (Goal statement) • Blood pressure will be 135/80 or better • I will be able to sleep restfully at least 7 hours each night • At least 5 out of every 7 days I will not get into fights with my partner • At least 5 out of every 7 days I will rate my happiness at a 3 or better. • I will acquire a job that pays at least $15/hour Making it Measurable • Measurable means an third person can look at the data and say “yes” it was accomplished or “no.” • Frequency (of the new behavior) • Number of days per week (went to work, went to meetings…) • Number of times per day (used a positive coping strategy) • Intensity (of the new behavior) • Anchored likert scale (use different words) • 1=extremely depressed 2=moderately depressed 3=content 4=happy 5=elated • 1= none 2=a little 3=feeling confident 4=I’ve got this Making it Measurable • Duration (of the new behavior) • Will resolve within 5 minutes (tantrum, panic attack) • Will pass in less than 30 minutes (urge, grief, anger) • Number • List 10 examples… • Scales • Beck Depression Inventory will drop 2 points

Achievable/Attainable • What can the person realistically do in the given time (i.e. 90 days) • Enroll in school • Get a job • Stay clean for 30 days • Rate her mood a 3 or better on the depression scale 5 out of 7 days • Increase the frequency that unhelpful thoughts are identified and effectively disputed to at least 70% Relevant • Objectives need to clearly related back to goals which need to clearly relate back to the reason for the referral. • Anyone reading the plan must be able to easily understand why each objective and intervention are there • In the goal statement, after the as evidenced by, add a statement, this is important to my [recovery] because… Time-Limited • All goals need to be able to be completed within the treatment period. • Objectives need to be constructed so they can be completed • For children through 5th grade…daily (even if just a star chart) • For youth 12 and up …weekly. Documentation • Plans are constructed WITH the client • Clients get a copy of their plan Progress Notes • If it isn’t documented, it didn’t happen. • Notes are dated, signed, and legible. • Client name and identifier are included on each page • Referral information has been documented. • Sources of information are clearly documented. • Client strengths and limitations in achieving goals are noted and considered. • Documentation should reflect changes in client status including response to and outcome of interventions • Entries should include the clinician’s professional assessment and continued plan of action

Progress Notes • Client review sheets can be helpful (complete at the end of session with the client) • Identify the problems and objectives you worked on this week. • Problem # ___ • Objective: _____ • Did you complete it? Yes No If no, why not? • What help do you need with this objective, if any? • Was it useful? Yes No If no, why not? • What else could you do to address this problem that would be more useful? • What problems and objectives are you going to work on next week? • Give a copy to the client.

Progress Notes • Progress Notes (S.O.A.P.) • Subjective – the client’s observations or thoughts; a client’s direct statement • Objective – the clinician’s objective observations during the session. • If you must use a subjective term like “withdrawn,” follow it with as evidenced by… • Mental-status: Orientation (person, place, time), memory, language, future plans • Assessment of Progress • Should identify each goal/objective worked on and outcome • Plans for next session

Summary • Addiction Severity Index can be used for clinical applications and assist in program evaluation activities because it assesses multiple domains of functioning which can be linked to Maslow’s heirarchy • Program-driven plans fit the patient into services. • Individualized plans fit the services to the patient • Treatment plan goals and objectives should be positive, Specific, Measurable, Attainable, Relevant and Time Limited • It is important to tie the treatment plan to the assessment and the interventions and client progress to the plans. • Why is the action being taken • How does it benefit the client in achieving goals • What was done this past week (include client activities and referral contacts) • What was the client response to those activities • What are the plans for next week • What referrals were made (if any) and why

AllCEUs started providing affordable CEUs and counseling continuing education, including online ceus and webinar based counseling ceus, in 2006 to help counselors licensed by their state board of professional counseling or state board of alcohol and drug abuse access affordable counselor continuing education, meet their continuing education requirements and enhance their addiction or mental health counseling practice. Since then, other companies have joined the marketplace to provide lpc continuing education including quantumunitsed, ce4less, Aspira aspirace, tzkseminars, i-counseling, accessceu, CEUbynet, pdresources. AllCEUs pioneered the model of offering unlimited CEU packages for a flat rate. We also were the first to offer live webinars each week for $5 per counseling webinar. We pride ourselves on having the largest catalog, with well over 200 multimedia, online counseling CEU courses. AllCEUs is an approved continuing education provider by the Connecticut Certification Board, The Florida Certification Board, FCB, The Alcohol and Drug Abuse Counseling Board of Georgia, ADACB-GA, NAADAC, the association for addiction professionals, the Texas Board of Social Work, The Texas Board of Professional Counseling, The Texas Board of Marriage and Family Therapy, California Consortium of Addiction Programs and Professionals, the Florida Board of Social Work, Mental Health Counseling and Marriage and Family Therapy and many other boards. It is important to note that, in most states, CEUs are NOT required to be NBCC approved, and most states accept ceus which are NOT from an NBCC approved continuing education provider or ACEP. For specific information about which other approval bodies your state accepts, you can visit our approvals page: https://cdn1.allceus.com/wp-content/uploads/2017/01/NewStateApprovalChart2017-1.pdf which provides a summary and links to the documents of the various state licensing boards for counselors, therapists and social workers. For mental health counselors, social workers and marriage and family therapists in Florida, AllCEUs reports your counseling CEUs to CE Broker. Whether you are a LCSW, MSW, LMFT, LMFT LMHC, LPC, LPCC, LCPC, CCMHC, MHC, CADC, LADC, CAP, LCDC, recovery coach, psychotherapist, pastoral counselor, addiction counselor, substance abuse counselor, recovery specialist, behavioral health technician needing mental health or addiction counseling CEUs online, or wanting to get certified as an addiction professional, AllCEUs has a variety of affordable online counseling CEUs, online addiction counselor certificate training tracks and face to face training options. Our unlimited CE packages provide professional counselor continuing education (CEUs) in addiction counseling, transdisciplinary foundations of addiction counseling, screening and assessment, diagnosis, family therapy, pharmacology, psychopharmacology, case management, crisis intervention, counseling tools, dialectical behavior therapy, mindfulness, acceptance and commitment therapy, ethics, supervision, working with adolescents, and many more.